Multi-family Therapy and School Refusal: an Exploratory Study With Adolescents and Their Families (Multi-Fast)

The purpose of this study is to determine whether multi-family therapy is effective in the treatment of school refusal with anxiety in adolescence.

Study Overview

• Status: Completed
• Conditions: School Phobia
• Intervention / Treatment: Behavioral: Multi-family therapy

Detailed Description

Anxious school refusal in adolescence is a major public health problem. The involvement of families is essential and multi-family therapy has shown its effectiveness for many mental disorders. This study aims to explore the benefit of multi-family therapy in the care of anxious school refusal in adolescence.

The method will be qualitative with phenomenological analysis of semi-structured interviews with adolescents and their parents and quantitative with a SCED design to assess the evolution of the level of anxiety of adolescents and parents, as well as personalized objectives.

The objective is therefore to improve the care of adolescents with anxious school refusal.

• Study Type: Observational
• Enrollment (Actual): 74

Contacts and Locations

Study Locations

• France
  • IDF
    • Paris, IDF, France, 75014
      • Maison de Solenn Maison des Adolescents, Cochin Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Cochin Hospital, Maison de Solenn-Maison des Adolescents, Paris, AP-HP Primary care clinic, Day care clinic

Description

Inclusion Criteria:

• Families with an adolescent
• Aged 12 to 18
• Totally out of school for more than 2 consecutive weeks and less than 18 months
• Follow-up at the Maison de Solenn-Maison des Adolescents (Cochin Hospital AP-HP) for a school refusal
• Having agreed to participate in a multi-family therapy
• Domiciliation in Ile de France
• Agreement of the parents and the adolescent to participate in the study: Collection of the non-opposition of non-emancipated minors and their legal representatives

Exclusion Criteria:

• any family situation that makes it impossible to bring parents and children together in family therapy
• patient under curatorship or tutorship
• patient with AME (french State Medical Aid)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Adolescents	Behavioral: Multi-family therapy; 8 sessions of Multi-family therapy of 3 hours each during 24 weeks
Parents	Behavioral: Multi-family therapy; 8 sessions of Multi-family therapy of 3 hours each during 24 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale (VAS)	Visual Analogue Scale for anxiety (adolescents and parents) / 0 = no anxiety at all, 10 = maximum anxiety imaginable / Weekly measurement between inclusion and the end of the Single Case Experimental Design (SCED) follow-up (13 to 15 months)	13 to 15 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Goal Attainment Scale (GAS)	School attendance (adolescent) / 3-terminal GAS are 5-level GAS, i.e. with a possible rating ranging from -2 to +2. Level -2 corresponds to the initial state at the time of inclusion. Levels -2, 0 and +2 are precisely described, level -1 corresponds to a rating between -2 and 0 and level +1 to a rating between 0 and +2 / Weekly measurements, parents and adolescent, once a week from inclusion to the end of the SCED follow-up (13 to 15 months)	13 to 15 months
Adolescent Depression Rating Scale (ADRS)	Depression (adolescent) / 10 questions / Monthly measurements, adolescent and referring psychiatrist once a month from inclusion to the end of the SCED follow-up (13 to 15 months)	13 to 15 months
Family Assessment Device General Functioning (FAD-GF)	Family functioning / 12 questions, minimum = 12, maximum = 48 / Monthly measurements, parents and adolescent, once a month from inclusion to the end of the SCED follow-up (13 to 15 months)	13 to 15 months
Global Assessment of Functioning Scale (GAF)	Global Functioning of the adolescent / From 0 = inadequate information, to 100 = higher level of functioning in a wide variety of activities - V-axis of the DSM 5 / Monthly measurements, referring psychiatrist, once a month from inclusion to the end of the SCED follow-up (13 to15 months)	13 to 15 months
CSQ 8 (Client Satisfaction Questionnaire)	Satisfaction of the patients and the parents with multi-family therapy / 8 questions, minimum score = 8, maximum = 32 / At the end of the multifamily therapy, parents and teenager	7 to 9 months
Semi-structured interview	Semi-structured interview with qualitative phenomenological analysis (patients and parents) At the end of multi-family therapy	7 to 9 months
Semi-structured interview	Semi-structured interview with qualitative phenomenological analysis (patients and parents) 12 months after the end of multi-family therapy	19 to 21 months

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborators: URC-CIC Paris Descartes Necker Cochin
• Investigators: Study Director: Marie-Rose MORO, MD, PhD, PU-PH, Cochin Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP); Principal Investigator: Aurélie HARF, MD, PhD, Cochin Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP)

Study record dates

Study Major Dates

• Study Start (Actual): September 12, 2022
• Primary Completion (Actual): March 2, 2024
• Study Completion (Actual): March 13, 2025

Study Registration Dates

• First Submitted: June 14, 2022
• First Submitted That Met QC Criteria: June 20, 2022
• First Posted (Actual): June 27, 2022

Study Record Updates

• Last Update Posted (Actual): May 20, 2026
• Last Update Submitted That Met QC Criteria: May 18, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Adolescence; Anxiety disorder; School Phobia; Multi-family therapy
• Additional Relevant MeSH Terms: Mental Disorders; Phobic Disorders; Anxiety Disorders; Phobia, School; Psychotherapy; Behavioral Disciplines and Activities; Socioenvironmental Therapy; Psychotherapy, Group
• Other Study ID Numbers: APHP211594; 2021-A01853-38 (Other Identifier: France : national drug safety agency)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No